Managing the credentialing, payer enrollment, and provider onboarding processes for physicians and advanced practice providers.
Ensuring providers are credentialed, enrolled, and maintained with commercial and government payers in a timely and accurate manner.
Maintaining provider records, monitoring credentialing deadlines, and coordinating with payers and providers.
Modena Health (MH) and Modena Allergy & Asthma (MAA) are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona, and ambitious plans for national expansion. They are physician-led, hospitality-focused, and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
Manage initial credentialing and re-credentialing applications for physicians and mid-level providers across multiple U.S. states.
Complete and maintain CAQH ProView profiles, ensuring all provider data is accurate, current, and attestation-ready.
Submit and track payer enrollment applications with commercial insurance companies, Medicare, and Medicaid programs.
AMS Solutions is a leading medical billing and revenue cycle management company serving healthcare practices across the United States. They specialize in helping physicians maximize their revenue through expert billing, coding, credentialing, and practice management services.
Manage end-to-end delegated credentialing operations across an assigned portfolio of payors.
Prepare, coordinate, and execute both pre-delegation and annual credentialing audits.
Build and deliver reporting packages for submission to delegated entities & payors.
Grow Therapy is a company that serves as a trusted partner for therapists growing their practice, and patients accessing high-quality care. They are powered by technology as a three-sided marketplace that empowers providers, augments insurance payors, and serves patients with over ten thousand therapists and hundreds of thousands of clients across the country.
Execute day-to-day provider enrollment, credentialing, and licensing tasks under guidance.
Input, maintain, and update provider data across databases and internal systems.
Review and process enrollment applications, supporting documentation, and status updates.
Allara is a women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams and is trusted by over 60,000 women nationwide.
Own & Manage Provider Relationships : Serve as the primary point of contact for provider primary care partners.
Support Provider Recruitment Activities as Product SME : Partner with CA GTM team to execute a provider onboarding and training best practices.
Optimize Provider Success & Retention : Implement and oversee a structured engagement plan to ensure providers maximize their use of our platform.
Counterpart Health is transforming healthcare with its AI-enabled primary care tool, Counterpart Assistant, that supports early diagnosis and management of chronic conditions. They drive value-based care at the speed of software with a team of value-based care and technology experts.
Research, interpret, and evaluate information relevant to provider licensure and continuing medical education in the United States.
Complete applications for provider credential, licensure or payor enrollment on behalf of Certify customers.
Validate and authenticate information updated on the credentialing, licensing platform and ensure 100% accuracy.
CertifyOS is building the data infrastructure that powers modern healthcare. Their API-first platform automates provider licensing, enrollment, credentialing, and network monitoring by connecting directly to hundreds of primary data sources. The company values authenticity, accountability, collaboration, results, and openness to feedback.
Manage day-to-day credentialing and re-credentialing workflows for Tia’s provider network.
Support medical licensing workflows for MDs, DOs, NPs, PAs, and RNs across multiple states, including tracking requirements, deadlines and renewals.
Track onboarding progress and help ensure providers are licensed, credentialed, enrolled, and compliant before go-live.
Tia is building a new model for women’s healthcare, one that treats women as whole people. They are a Series D, venture-backed company trusted by more than 120,000 women across four markets, building a culture of excellence in people, process, and product.
Develop product requirements supporting CMS Medicare FFS provider data standards including NPI validation, taxonomy classification and provider file maintenance aligned to HIPAA requirements.
Ensure provider configuration capabilities align with CMS enrollment, credentialing and revalidation mandates including PECOS data alignment and provider directory accuracy obligations.
Translate CMS provider data regulatory updates into structured product requirements and backlog items while partnering with implementation teams to identify and remediate compliance gaps.
HealthEdge provides an integrated platform of solutions that enables health plans to converge their data and harness insights to improve outcomes. The company has a team of visionary, empathetic people who believe technology should remove friction from healthcare and operate with agility as the regulatory landscape evolves.
Serve as the primary contact for CM/UM programs and operational questions related to the MyCare Platform.
Build relationships with provider offices through outreach and timely follow-up, resolving issues within defined turnaround times.
Educate providers on submission requirements, documentation, timelines, and available CM/UM resources.
Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes.
Communicating with providers regarding claims, service issues and general network provider complaints.
Developing an adequate provider network in assigned geographical areas (currently Texas metroplex areas).
Building and maintaining relationships with contracted providers, including inquiries related to contract status, roster corrections and information accuracy.
Evry Health, a Globe Life company, aims to bring humanity to health insurance. They are a high-technology health plan expanding benefits and access, and feature a personalized, human approach. Globe Life has 16.8 million policies in force, with more than 3,000 corporate employees and 15,000 agents.
Own end-to-end enrollment outcomes for your customer portfolio and be accountable for SLA performance and client satisfaction.
Manage an on/offshore team of enrollment specialists: set goals, build capacity plans and develop talent.
Identify and resolve root causes of client issues by coordinating cross-functional teams.
Medallion is a leading provider operations platform that eliminates administrative bottlenecks for healthcare organizations. They are one of the fastest-growing healthcare technology companies backed by $130M in funding from world-class investors, revolutionizing provider network management.
Primarily responsible for making outbound calls to healthcare providers.
Accepting inbound calls from healthcare providers.
Answer questions about participation requirements, registration, assessment completion and scoring results.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With over 66,000 employees, we combine scale, expertise and execution to create meaningful, measurable impact.
Own product requirements for Medicare FFS enrollment workflows within HealthRules Payer, including enrollment transaction processing and plan benefit package configuration.
Drive accumulator configuration requirements for deductible, out-of-pocket maximum and benefit limit tracking across claim types and benefit periods.
Evaluate CMS rulemaking cycles and annual benefit design updates to assess downstream impact on HealthRules Payer configuration and adjudication behavior.
HealthEdge provides an integrated platform of solutions that enables health plans to converge their data and harness insights to improve outcomes. We are a team of visionary, empathetic people who believe technology should remove friction from healthcare and operate with a collaborative culture focused on making a real difference for payers and their members.
Drive outbound outreach to healthcare providers to promote Nomi Pay solutions.
Educate healthcare organizations on the benefits of electronic payments.
Build strong provider relationships while identifying opportunities to increase enrollment.
Nomi Health is rebuilding the healthcare system to provide clear prices, faster payments, and data-driven decisions. They have a team of 300+ people and partner with employers, public sector organizations, advisors, and payers to deliver disruptive healthcare solutions.
Deliver an outstanding customer experience by supporting inquiries across phone, email, text, and chat.
Manage high-complexity insurance workflows and inbound support requests to collect documentation.
Partner with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment and continuity of care.
Expressable is a virtual speech therapy practice that aims to transform care delivery and expand access to high-quality services. Since 2019, they serve thousands of clients with a focus on parent-focused intervention and an e-learning platform with home-based learning modules.
Help develop and execute the provider growth playbook.
Generate leads, contact therapists and drive therapist contracting.
Partner with onboarding teams and other operations teams to translate sales insights into business improvements.
BetterHelp's mission is to remove the traditional barriers to therapy and make mental health care more accessible. Founded in 2013, they are the world’s largest online therapy service, providing affordable and convenient therapy across the globe.
Perform outbound calls to engage patients about the benefits of Salvo’s program and tech-enabled services.
Enroll patients in Salvo’s program and schedule an initial virtual nurse visit to onboard patients.
Assist patients in understanding the cost of the program, including insurance coverage and financial responsibilities.
Salvo Health offers virtual care to patients at community specialty care practices, focusing on chronic gut health and metabolic conditions. The company has raised a Series A investment round and aims to provide continuous, interdisciplinary wraparound care.